Clinical orthotopic liver transplantation will be carried out on approximaltely 30 patients per year using improvements in surgical, diagnostic and management techniques that have recently evolved. Cyclosporin A with prednisone will be used for immunosuppression. Patients with inborn errors of metabolism will have biochemical studies dictated by the nature of the enzyme defect and metabolic abnormalities. Supporting laboratory investigations will be directed to the development of better methods of liver preservation and evaluation of auxiliary liver transplantation for the treatment of acute hepatic failure.